Oscar logo
Oscar

Award-winning recruitment consultancy; delivering talent across Tech, Digital, Life-Sciences, Energy & Construction

Physician Reviewer – Utilization Management

Location

Arizona + 2 moreAll locations: Arizona | Florida | North Carolina

Posted

38 days ago

Salary

$211.2K - $277.2K / year

Seniority

Senior

Postgraduate Degree6 yrs expEnglish

Job Description

Physician Reviewer – Utilization Management

Oscar

• Determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines • Provide timely medical reviews that meet Oscar's stringent quality parameters • Provide clinical determinations based on evidence-based criteria and Oscar internal guidelines and policies, while utilizing clinical acumen • Clearly and accurately document all communication and decision-making in Oscar workflow tools • Use correct templates for documenting decisions during case review • Meet the appropriate turn-around times for clinical reviews • Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and explain review outcome decisions • Compliance with all applicable laws and regulations

Job Requirements

  • Board certification as an MD or DO
  • Licensed in one of these states: FL, NC, AZ OR possess an active Interstate Medical Licensure Compact (IMLC)
  • 6+ years of clinical practice

Benefits

  • Health insurance
  • 401(k) plan participation
  • Paid parental leave
  • Paid sick time
  • Paid time off
  • 11 paid holidays
  • Unlimited vacation
  • Annual performance bonuses

Related Categories

Related Job Pages

More General Jobs

Behavioral Health Tech logo

Care Experience Quality Lead

Behavioral Health Tech

Join us at BHT2025 on Nov 11-13, 2025! Expanding access to behavioral health through tech, health equity & innovation.

General38 days ago
Full TimeRemoteTeam 1-10Since 2020H1B No Sponsor

• Manage the end-to-end process of handling customer complaints, ensuring timely and satisfactory resolutions. • Investigate root causes of complaints and implement corrective actions to prevent recurrence. • Serve as the primary point of contact for escalated client issues, addressing concerns promptly and effectively. • Develop and implement quality assurance protocols and standards to uphold service excellence. • Conduct regular audits, monitor performance metrics, and identify areas for improvement. • Collaborate with other departments to address systemic issues and improve overall customer satisfaction. • Analyze customer feedback, complaints, and service metrics to identify trends, patterns, and areas for improvement. • Use insights to drive strategic decision-making and enhance the customer experience. • Continuously evaluate and refine internal processes related to complaint handling, escalation management, and quality assurance.

United States
Behavioral Health Tech logo

Clinical Supervisor – Southeast

Behavioral Health Tech

Join us at BHT2025 on Nov 11-13, 2025! Expanding access to behavioral health through tech, health equity & innovation.

General38 days ago
Full TimeRemoteTeam 1-10Since 2020H1B No Sponsor

• Assist the Clinical Director to develop and implement an engaging clinical schedule, including the development of curriculum • Ensure that clinical services are delivered in accordance with recognized best practices • Crisis management throughout all intensive outpatient program delivery/on-call responsibilities throughout nights/weekends • Maintain a caseload and facilitate weekly group treatment (15 hours minimum) • Well versed in a variety of modalities and feel confident integrating them into your treatment approach (DBT, CBT, EMDR, MI certification is a plus) • Communicate clearly and professionally with clients, staff, families, agencies, and referents • Ensure compliance to regulations set forth by The Joint Commission and perform ongoing quality assurance • Monitor treatment documentation to ensure all notes are included and meets agency and professional standards per DHCS and The Joint Commission standards • Provide clinical supervision in accordance with regulatory requirements and accreditation standards • Maintain and model professional ethics, including appropriate boundaries and confidentiality • Assist with the development of relationships with key referral sources, participate in networking

United States
$65K - $85K / year
Backpack Healthcare logo

Outpatient Psychiatrist

Backpack Healthcare

Breaking barriers and healing young minds with inclusive, accessible, and comprehensive mental healthcare.

General38 days ago
Part TimeRemoteTeam 51-200H1B No Sponsor

• Conduct psychiatric evaluations and assessments across the lifespan • Diagnose and manage ADHD, anxiety, depression, mood disorders, trauma-related conditions, and more • Develop individualized treatment plans including medication management and therapy recommendations • Collaborate with therapists, PMHNPs, primary care providers, schools, and families • Provide crisis intervention and ongoing support as needed • Participate in team meetings and clinical consultations • Maintain accurate, timely documentation in compliance with HIPAA and Georgia regulations • Stay current on developments in psychiatric care and evidence-based treatment

United States
Vituity logo

Physician - Tele-Neurohospital Medicine

Vituity

A physician-led-and-owned healthcare delivery organization, Vituity offers integrated, acute care expertise in the areas of anesthesiology, emergency medicine,

General38 days ago

Role Description Join the Physician Partnership Where You Can Increase Your Impact. Vituity’s ownership model provides autonomy, local control, and a national system of support, so you can focus your attention where you want it to be – on your patients. Seeking Board Eligible/Certified Tele-Neuro physicians. Current TN state license or IMLC compact is a plus. Qualifications - Board Eligible/Certified Tele-Neuro physicians - Current TN state license or IMLC compact is a plus Requirements - Ability to work remotely while being an important part of the Vituity Community Benefits - Superior Health Plan Options - Dental, Vision, HSA, life and AD&D coverage, and more - Partnership models allow a K-1 status pay structure, allowing high tax deductions - Extraordinary 401K Plan with high tax reduction and faster balance growth - Eligible to receive an Annual Profit Distribution/yearly cash bonus - EAP and travel assistance included - Student loan refinancing discounts - Purpose-driven culture focused on improving the lives of our patients, communities, and employees

United States